Shared decision making in care for the gynecologic cancer patient
Steffensen KD, Fokdal LU, Oer Knudsen A, Vestergaard Madsen C, Jensen PT, Lundvall L, Olling K, Lemley B, Blou D, Büchmann H, Haee M
Introduction: Treatment of recurrent ovarian cancer is complex and may involve surgery, chemotherapy or surveillance options that should be discussed with patients to reach a shared decision.
This project aims to develop and test a patient decision aid (PDA) to facilitate shared decision making (SDM) in treatment planning of the ovarian cancer patient with relapse and furthermore, to evaluate SDM implementation methods
Material & Methods: Development, testing, evaluation, and implementation of a PDA for women with relapsed ovarian cancer will be performed at three hospitals in Denmark. The test phase will include; 1) Alpha test: Patients and clinicians are interviewed based on a structured interview guide based on internationally validated questionnaires used to assess, to what extent the PDA prepare the patient to make a decision. 2) Betatest: Validated outcome measures, such a SDM-Q9, SDM-Q-DOC, OPTION and CollaboRATE will be used to assess patients and doctors experiences of SDM in consultations with patients experiencing a disease relapse at baseline before introduction of the PDA (Betatest 1) and after the use of the PDA (Betatest 2)
Results: Based on an existing generic platform we have developed a PDA for platinum-sensitive as well as platinum-resistant relapse. The patient-clinician conversation in which the PDA is used consists of 5 steps: 1) The purpose of the PDA is presented 2) The patient is informed of the available treatment possibilities 3) The patients personal preferences is identified, what is important/concerns the patient 4) Patient's options and harms/benefits of each option are reviewed 5) A shared treatment decision is made with the patient
Conclusions: The project results are intended to be disseminated on a national level through the Danish Gynecological Cancer Group for the benefit of other cancer patients. The generic PDA template can also be adjusted and used to develop new tools for other clinical decisions within Danishhealthcare